Editorial: How the GOP just hurt everybody in Michigan

Sep. 5, 2013

The state Legislature decided not to give Medicaid expansion immediate effect. That decision means Michigan will lose out on $7million a day in federal funding and will leave those suffering without insurance wanting even longer. And nobody wins. / January photo by Ryan Garza/Detroit Free Press

Written by

Detroit Free Press Editorial Board

Correction: An earlier version of this editorial erroneously said the Michigan House of Representatives failed to give immediate effect to Medicaid expansion. The House granted immediate effect; it was the Senate that did not. The earlier version also mistakenly indicated that fines in 2014 for failing to have health insurance are monthly. They are annual.

Self-satisfaction and contempt.

Those curious emotions beamed from the Michigan Legislature on Tuesday, as the Senate refused to give immediate effect to Medicaid expansion.

Senate Majority Leader Randy Richardville was even agitated by the expectation that lawmakers might do more.

“It’s like we had this really big dinner,” Richardville said. “We got the dinner done and people are going to ask for dessert. We’re going to skip dessert on this one.”

Right. Because 470,000 Michiganders can just wait three months into 2014 to get health care. And the $7 million Michigan will forgo every day in federal funding for that 90 days? Whatever.

Michigan’s current crop of state lawmakers have indulged a large passel of wrongheaded policy-making since 2010. But none could be crueler or more foolish than the refusal to expand Medicaid as soon as possible.

This isn’t legislative pablum or other triviality. It’s about people’s lives, and significant reform that will help preserve those lives.

It would be different if immediate effect, which would have allowed new Medicaid recipients to get coverage in January, were anomalous. But the Republican majority has gorged on immediate effect more than 500 times in the last few years to enact a wide range of laws. (What was the rush, for instance, behind the repeal of the state’s motorcycle helmet law?) The GOP majority has even taken to “quick gaveling” immediate effect votes, to avoid actually counting to see that the required two-thirds of each chamber is voting in favor.

It also would be different if there were logic to back the Medicaid delay. But 470,000 uninsured Michiganders will suffer needlessly while we wait for the law to take effect. It won’t save the state money, but will cost us — in the lack of federal funding to subsidize Medicaid expansion and in the continued burden of uncompensated care in the state.

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The bill for uninsured patients in Michigan hospitals was $2.3 billion in 2011, according to the Center for Health Care Research and Transformation.

It gets worse: The enrollment period for new health insurance consumers begins in October of this year and ends in March 2014, just shy of the April date when the Medicaid expansion will take effect. And while the Michigan Consumers for Healthcare, a broad coalition of health care nonprofits, will help Michiganders navigate the acquisition of insurance (for some folks, this will be the first time they’ve selected or purchased care), the delay causes uncertainty.

The state will lose an average of $7 million a day in federal money — $630 million if delayed until April — designed to get newly eligible Michiganders enrolled in Medicaid, and folks without insurance may face the Affordable Care Act’s penalty, which in 2014 amounts to $95 for an individual and as much as $285 for a family.

So who loses here? Taxpayers. People with insurance. Potential new Medicaid recipients. And just about anyone with good sense.